Objective: To explore the characteristics of viral infections in children with diarrhea in Beijing from 2018 to 2022. Methods: Real-time PCR and enzyme-linked immunosorbent assay were used to detect viral nucleic acid of Norovirus (NoV), Sappovirus (SaV), Astrovirus (AstV), Enteric Adenovirus (AdV) or antigen of Rotavirus (RV) in 748 stool samples collected from Beijing Capital Institute of Pediatrics from January 2018 to December 2021. Subsequently, the reverse transcription PCR or PCR method was used to amplify the target gene of the positive samples after the initial screening, followed by sequencing, genotyping and evolution analysis, so as to obtain the characteristics of these viruses. Phylogenetic analysis was performed using Mega 6.0. Results: From 2018 to 2021, the overall detection rate of the above five common viruses was 37.6%(281/748)in children under 5 years old in Beijing. NoV, Enteric AdV and RV were still the top three diarrhea-related viruses, followed by AstV and SaV, accounting for 41.6%, 29.2%, 27.8%, 8.9% and 7.5%, respectively. The detection rate of co-infections with two or three diarrhea-related viruses was 4.7% (35/748). From the perspective of annual distribution, the detection rate of Enteric AdV was the highest in 2021, while NoV was predominant in the other 4 years. From the perspective of genetic characteristics, NoV was predominant by GⅡ.4, and after the first detection of GⅡ.4[P16] in 2020, it occupied the first two gene groups together with GⅡ.4[P31]. Although the predominant RV was G9P[8], the rare epidemic strain G8P[8] was first detected in 2021. The predominant genotypes of Enteric AdV and AstV were Ad41 and HAstV-1. SaV was sporadic spread with a low detection rate. Conclusion: Among the diarrhea-related viruses infected children under 5 years of age in Beijing, the predominant strains of NoV and RV have changed and new sub-genotypes have been detected for the first time, while the predominant strains of AstV and Enteric AdV are relatively stable.
目的： 探讨2018—2022年北京市儿童腹泻病例常见病毒感染型别。 方法： 分别采用荧光定量PCR法或酶联免疫法检测2018年1月至2022年12月在北京市首都儿科研究所采集的748份腹泻儿童病例粪便标本中常见病毒的核酸（诺如病毒、札如病毒、星状病毒、肠道腺病毒）或抗原（轮状病毒）。随后对初筛阳性样本采用反转录PCR或PCR方法进行目的基因扩增测序并开展基因型和进化分析，获得儿童腹泻病例常见病毒感染情况及基因型别，采用Mega6.0软件进行系统进化分析。 结果： 2018—2022年北京市5岁以下腹泻儿童的常见病毒总体检出率为37.6%（281/748），诺如病毒、轮状病毒和肠道腺病毒的占比位于构成儿童腹泻相关病毒的前三位，其次为星状病毒和札如病毒，构成比依次为41.6%（117/281）、29.2%（82/281）、27.8%（78/281）、8.9%（25/281）和7.5%（21/281）；两种或三种腹泻相关病毒混合检出率为4.7%（35/748）。从年度分布来看，2021年肠道腺病毒的检出率最高，而其他年份均为诺如病毒检出率最高。从基因特征来看，诺如病毒以GⅡ.4型为主，且2020年首次检出GⅡ.4［P16］亚型后，与GⅡ.4［P31］亚型一起占据前两位基因群。轮状病毒虽然以G9P［8］为主要流行株，但是2021年开始检测到G8P［8］型。肠道腺病毒和星状病毒的主要流行株分别为Ad41和HAstV-1。札如病毒检出率仍较低，散发趋势明显。 结论： 北京地区5岁以下儿童腹泻病例中的诺如病毒和轮状病毒的优势流行株检测到了新亚型，星状病毒和肠道腺病毒的流行株较为稳定。.